Association of GLP-1 receptor agonists with risk of intestinal obstruction in patients with type 2 diabetes mellitus: a retrospective cohort study

Abstract

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for treating type 2 diabetes and weight loss. There have been concerns that GLP-1RAs may increase the risk of intestinal obstruction. Objective: Investigate the association between GLP-1RAs use and intestinal obstruction in a large cohort of patients with type 2 diabetes mellitus (T2DM) in the U.S. Design: A retrospective cohort study was conducted using longitudinal electronic health records sourced from TriNetX, a large-scale, population-based health database. Participants: The study included over 1.2 million T2DM patients who were prescribed anti-diabetic medications, including 181,795 prescribed GLP-1RAs between April 2013 and April 2019. Main measures: The incidence of intestinal obstruction was compared between GLP-1RAs and each of six other classes of non-GLP-1RA anti-diabetic medications. Hazard ratios (HRs) at 1, 3, and 5-year follow-up periods were calculated using Cox proportional hazards analysis. Separate analyses were performed in T2DM patients with and without obesity. Key results: The risk of intestinal obstruction did not differ between GLP-1RAs and other anti-diabetic medications except for a reduced risk compared with insulins. The results were consistent for 1, 3, and 5-year follow-up periods and in patients with and without obesity. Conclusions: Our findings do not support an increased risk of intestinal obstruction in T2DM patients prescribed GLP-1 RAs compared to other anti-diabetic medications.